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The association between infection with Gram-negative bacteria and autoimmune diseases has been investigated with controversies about the role of the organisms especially, Helicobacter pylori (H. pylori). To evaluate the impact of the presence and activity of H. pylori on the disease activity in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS). This study was carried out on one hundred adult patients and 50 controls. Patients included 40 RA, 40 SLE, and 20 AS. Participants were subjected to clinical examination and laboratory investigations; ESR (spectrophotometric assay), CRP (turbidimetric method), serum H.pylori IgG antibody test (enzyme immunoassay), and H. pylori antigen test (lateral flow immunoassay, rapid one-step test) in stool. Positive test in stool indicated active current H. pylori infection. Mean age of patients was 36.95±10.34; 51.2±6.91, 35.5±3.71, and 48.82±5.81 in SLE, RA, AS, and control groups respectively. Serum H. pylori IgG antibodies was 0.803±0.497 U/mL in SLE group, 1.48±0.637 U/mL in RA group and 0.75±0.68 U/mL in AS group while it was 0.2±0.61U/mL in the control group with a significant difference (P=0.000). The H. pylori antigen in stool was found positive in 30%, 70% and 20% of patients of the three groups respectively while it was positive in 10% of the control group with P>0.001. Patients with active SLE (SLEDAI >3) and RA (DAS-28 >3.2) demonstrated higher frequency of positive test for H. pylori antigen in stool than patients at remission (66.7% P= 0.02 and 83.3% P= 0.01 respectively). In contrast, 22.2% of patients with active AS (BASDAI > 4) were positive for H. pylori in stool. In conclusion, H. pylori infection is associated with increased disease activity in patients with SLE and RA but not AS.

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Introduction and aim: Osteoarthritis (OA) is the commonest degenerative and painful articular disease. It is a significant cause of disability. Early diagnosis is crucial and searching for biomarkers is continuing. The current work aimed to assessment the plasma leptin and adiponectin concentrations in patients with primary knee osteoarthritis (OA), and to explore the relationship of leptin and adiponectin with OA severity Methodology: Forty patients with primary knee osteoarthritis from both sexes who fulfilled ACR criteria for diagnosis of knee OA were enrolled. Other healthy subjects were included as a control group.  Patients were sassed by history taking, clinical examination, radiological and laboratory investigations. WOMAC questionnaire was used to evaluate a patient’s functions. Results: Both study and control groups were comparable as regards to patient demographics, except their weight, height and body mass index (BMI). Obesity, hypertension, tenderness, pain grade, limitation of joint movements and WOMAC score, Kellgren Lawrence radiological criteria, leptin and adiponectin were increased in study when compared to control group.  There was significant, positive, moderate correlation between leptin and BMI (r=0.557, p < 0.001). Higher leptin was associated with obesity and diabetes mellitus. Leptin serum levels revealed proportional, moderate, significant correlation with each of pain, stiffness and K-L criteria, while this correlation was powerful with physical function and total WOMAC score. Conclusion: Leptin and adiponectin were increased in patients with osteoarthritis. Leptin alone is significantly associated with disease severity indices.